- Title Pages
- List of figures and tables
- One Case studies in health policy: an introduction
- Two Case studies of the health policy process: a methodological introduction
- Part Two Creation, Consolidation and Disillusion (1948–1980s)
- Three NHS birthing pains
- Four Hospital policy in England and Wales: of what is the 1962 Hospital Plan a case?
- Five The case study as history: ‘Ideology, class and the National Health Service’ by Rudolf Klein
- Six Hospitals in trouble
- Seven <i>Normal accidents</i>: learning how to learn about safety
- Eight Repressed interests: explaining why patients and the public have little influence on healthcare policy: Alford's concepts of dominant, challenging and repressed interests
- Part Three ‘safe In Our Hands’: Conflicts and Challenges (1980s and 1990s)
- Nine The 1983 Griffiths Inquiry
- Ten<i>Aids in the Uk: The making of policy, 1981–1994</i> (Berridge, 1996): a case-study in British health policy
- Eleven What the doctor ordered: the Audit Commission's case study of general practice fundholders
- Twelve Coping with uncertainty: Policy and politics in the National Health Service (Hunter, 1980)
- Thirteen <i>Shaping strategic change</i>: changing the way organisational change was researched in the NHS
- Part Four The new NHS? The NHS since the 1990s
- Fourteen Patient choice: a contemporary policy story
- Fifteen The individualisation of health: health surveillance, lifestyle control and public health
- Sixteen NHS confidential: Implementation, or … how great expectations in Whitehall are dashed in Stoke-on-trent
- Seventeen Implementing clinical guidelines: a case study of research in context
- Eighteen <i>Accidental logics</i>, Carolyn Hughes Tuohy's analysis of the English National Health Service internal market of the 1990s
- Nineteen Evidence and health inequalities: the Black, Acheson and Marmot Reports
- Twenty Policy learning from case studies in health policy: taking forward the debate
- Twenty-One Case studies in health policy: concluding remarks
Hospitals in trouble
Hospitals in trouble
- (p.95) Six Hospitals in trouble
- Shaping Health Policy
- Policy Press
The notion that hospitals can do harm as well as good was not a new one when John Martin published ‘Hospitals in Trouble’ in 1984. Institutions that are designed to care for and treat sick people sometimes damage or, occasionally, kill them. It is a paradox that remains today in every health system and it is why this case study is of continuing importance. The roots of failure go very deep and can rarely be attributed to the actions of one or two rogue professionals. Things that go wrong have to be seen in the context of systemic failure, deriving from problems of organisational culture, poor leadership, and other complex factors.
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